I first met Dr. Levy during my Fellowhip in Psychosomatic Medicine at State Universtiy of New York , Downstate Medical Center in Brooklyn, New York where he was a senior attending on the Service of the reknowned medical researcher Dr. Franz Reichsman. During this time Dr. Levy collaborated with Dr. Eli Friedman, a leading nephrologist. Dr. Levy became the first researcher to identify and write about the connection and interaction of mind and body in patients with kidney disease many of whom were receiving dialysis. He ultimately wrote two books on this subject as well as numerous journal articles and chapters in various books. He also put together several international meetings on this subject where nephrologists, psychiatrists, psychlogists, social workers and nurses from all over the world presented papers and exchanged ideas .
Dr. Levy then came to New York Medical College in Valhalla, New York where he became Director of Consultation Liaison Psychiatry and he put together a team of which I was very pleased to be a member.
After several years there he returned to Brooklyn where he was elected Professor Emeritus of Psychiatry at State University of New York well as a Life Fellow of the American Psychiatric Association.
After many years on the east coast Dr. Levy relocated to Los Angeles where he has maintained a private practice until very rececently when he retired.
He enjoys spending time with his wife Belle and receiving visits from his son and 3 daughters and his grandchildren. By coincidence my wife Susan and I ended up in Los Angeles so we are able to enjoy time together with Belle and my dear teacher, colleague and wonderful friend.
I was very forutnate to have met Dr. Levy, early in my career and to have had him as teacher and mentor and then throughout the years work with him as a colleague. Now in our later years I am able to enjoy visiting with him as a dear friend and share our memories and the pleasures of growing old in beautiful Southern California.
(Dr. Blumenfield is the Sidney E. Frank Distinguished Professor Emeritus of Psychiatry and Behavioral Sciences at New York Medical College and currently in private practice in Los Angeles. He is the author of a new book “ShrinkTalk” scheduled to be released in June)
The pandemic has progressed to the point where we are trying to figure out why people are refusing or are reluctant to get vaccinated.
Months ago, we were struggling with the question as to why people were refusing to wear masks when it was clear that doing so could save thousands of lives. There were also thousands of people who would attend “super spreading events” where numerous people would become infected and many would die. I conceptualized this behavior as people using the unconscious defense mechanism of “denial” and I suggested that we label it “Fatal Denial.” I also suggested a plan to run “focus groups” to determine to whom the non-maskers might identify with and then to recruit them for a massive public affairs campaign on TV, Internet, billboards etc. (see earlier blog). Many of my colleagues expressed strong agreement with this conceptualization and recommendation although despite my efforts to bring this suggestion to political and media people, there were very few media presentations utilizing these ideas.
Now we are in a situation where we have a safe effective vaccine which is saving hundreds of thousands of lives. However, there are a significant number of people who refuse to get vaccinated or are “vaccine hesitant.” Because of this type of thinking, there is no doubt that many people will become infected and many will die. It also will become much more difficult to achieve “herd immunity.” We are seeing many experts appearing on TV urging people to get vaccinated and trying to explain the scientific validity of the vaccine. Hopefully, this will convince some of those who are hesitant or refusing to get vaccinated. However, I believe we need a stronger presentation to break through the “fatal denial” that is operating with these people.
I suggest that with every statistical presentation on the various media of the number of new cases and number of new deaths from Covid 19, it should also be stated and published what percentage of those fatalities were not vaccinated! In addition, there should be an effort on the part of the media to recruit people who were Anti Vaxxers and then survived a bout with this terrible disease to tell their story and how they regret their refusal to get the vaccine. Also, there should be a sensitive effort to bring to the attention of the public the first-hand story of family members who lost loved ones to the disease who had been against getting the vaccine.
I understand that I am suggesting that we approach people’s personal feeling about death and dying and also try to bring people’s personal pain and grief to public exposure albeit with their consent and agreement. I do this because I also understand that denial, and in this case “Fatal Denial” is a very powerful defense mechanism which has to be dismantled in order to save thousands of lives.
I think it is interesting that most of us experienced our own classical analysis and may have performed to varying degrees classical analysis where the patient lies on the couch and there is no eye contact with the therapist ! For many this was or may still be the gold standard.
Even when there is face to face therapy, to many the proper approach is for the therapist not to reveal emotions through facial expression. To do so could facilitate the development of a false transference etc etc. So now when we are forced to do remote therapy, I very much doubt that most therapists set up their screens so they are at least six feet away from their screen ( to reproduce the usual therapy setting ) or perhaps shut off their camera to do analysis in classical manner without patient seeing your face during the session. I believe that our profession has learned that we can come to understand transference in most settings, take into account and explore where our facial expression, objects in our office and information that the patient has obtained from the Internet will influence initial transference and use our techniques to interpret the patient perceptions and use analytic techniques to facilitate the therapy and help the patient.
(Dr. Blumenfield is the Sidney E. Frank Distinguished Professor of Psychiatry and Behavioral Sciences at New York Medical College and currently in private practice in Los Angeles. He is the author of a new book “ShrinkTalk” scheduled to be released in June)
It has been about 4 months since I first wrote about “Fatal Denial” and how this unconscious psychological defense mechanism is leading to thousands of preventable deaths during the Covid-19 pandemic. Denial is a well known unconscious psychological defense that we use in many situations on a regular basis. It is bolstered by another psychological mechanism of rationalizations such as a person accepting the idea that the need to wear masks is overblown, is a political issue or isn’t necessary if you are relatively young and healthy, etc. etc. The scientific facts and the reality are quite clear, in that the failure to wear masks and social distance is causing the continued increase in the number of Covid-19 cases and thousands of subsequent related deaths!!
The periodic and increased statements by scientists and health experts about the necessity to take these precautions apparently has not made any difference in this tragic situation.
I know that the people who are participating without masks and social distancing in public demonstrations and social gatherings do not want to get sick and die or cause loved ones to do the same. Nevertheless, the number of cases and fatalities continues to increase.
I have suggested that there is an approach to counter this trend which will utilize our understanding of the unconscious psychological mechanisms at play here. That would be to identify the “objects” (people) with whom the Fatal Deniers value and are their so-called heroes. This may be actors and actresses, sports figures, musicians and even in some cases politicians and other leaders. These people can be identified by running some “Focus Groups” (techniques well known to the advertising industry) with the “non maskers” who are utilizing “fatal denial”. These “heroes”( well known public figures) would then be approached and asked to participate in a massive public service outreach program that would include television, radio, Internet, billboards etc. in which they would plead with the public to save lives and wear masks, social distance etc. Also included in this public service outreach program would be segments with people who have lost loved because of COvid 19 perhaps some people who now realize how they have caused illness and death to loved ones by not taking the recommended precautions.
I have spoken to many colleagues in the mental health professions who agree with me in this analysis and suggested solution. I tried to bring these ideas to the attention of people who might be able to utilize them but so far have not made any progress. Such a program will require some financial support and hopefully cooperation of the media but surely it is worth any price.
The deadly Coronavirus epidemic continues to spread in my state of California and throughout the country. Medical experts have clearly identified the reason that the epidemic is getting out of control is that a significant number of people are not listening to the medical experts and are not using facial masks, keeping social distancing nor are they following other precautions concerning opening businesses, restaurants, beaches, sporting and political events etc. Of course, these people do not want to get sick or spread this illness to their loved ones. Such individuals are using a very common unconscious psychological defense mechanism of “denial” to keep out of their consciousness that their behavior could be fatal to themselves and their loved ones. They support this denial with another well-known psychological defense mechanism known as “rationalizations”. Examples are, “I am healthy and won’t get sick”, “These precautions by the experts are political in nature”, “You are only young once” and many other rationalizations. Because these are psychological defense mechanisms and they won’t protect anyone from this fatal virus, I have coined a new term for this denial and am calling it “FATAL DENIAL.”
In order to overcome this “fatal denial” we must communicate the message to the deniers as coming from people with whom they have a strong positive identification. There are well known scientific approaches to determine who such people would be. This is the technique of running focus groups with a wide cross section of deniers. (The advertising industry is quite skilled at utilizing this method). During such meetings it would not necessarily be important to determine the rationalization that are used but rather the scientific inquiry would be to identify who are their role models and heroes among movie, tv, music, sports and even political stars. Once these names were identified, they would be approached and be invited to participate in a massive public service announcement campaign which would speak to the Fatal Deniers. There should be TV and radio ads as well as billboards and posters as well as a concerted campaign on social media which could be made available throughout the country. In addition to the “heroes” being the face and voice of these announcements, there also should be series of such announcements done by young and older regular people who have lost loved ones to the virus.
While I would hope that celebrities might donate their time and perhaps networks would also donate free time for these pieces, there still would be costs in making them and distributing them. I would hope that Governor or California and the state legislature as well as their counterparts in other states would be interested in supporting such a program. I know TV producers who would be skilled and capable of carrying out such a program and I would be willing to help in any way that I can. Perhaps such people as Bill Gates, Jeff Bezos and others might get behind such a life saving program and provide the financial support needed.